Questions to ask a senior-living referral agency

Why a few questions help

Referral agencies (sometimes called placement agencies or senior living advisors) can save a family a lot of time. Most are free to families because the communities they recommend pay them. That arrangement is legal and common, but it shapes which places you hear about. A few direct questions tell you whose list you are looking at and what will happen to your contact details.

Ask about money

A good advisor will answer these plainly. If they won’t, treat that as an answer too.

• Who pays you, and when? Is it a fee when we move in, a monthly fee, or something else?
• Roughly how much is the fee, and is it the same for every community you recommend?
• Do you only recommend communities you have a contract with?
• Would you tell us about a good community nearby that doesn’t pay you?
• Will using you ever cost us anything, now or later?

Ask about your contact details

Your phone number and email are what an agency passes on. Decide who gets them before you fill in a form.

• Which communities will you send our name, phone number and email to?
• Can we approve each community before you share our details?
• How many calls or texts should we expect, and from whom?
• How do we stop calls and texts from you and from the communities?
• Do you keep our details afterwards, and do you share them with anyone else?

Ask about care quality

A friendly tour and good online reviews don’t tell you what state inspectors found. Ask how the agency checks.

• Have you or your team visited this community in person? When?
• Can you show us its latest state inspection report, and for a nursing home, its Medicare Care Compare page?
• Do you recommend communities with recent citations for neglect or understaffing? How would we know?
• Who collects the reviews on your site, and can communities influence which families are asked for one?
• What does an award or badge on your site actually measure?

Ask about budget and Medicaid

Communities that accept Medicaid, or cost less, may not be part of a paid network. Ask whether the agency works with families who plan to use Medicaid or a VA benefit, and whether they will tell you when a community’s price is above your budget instead of suggesting you stretch it.

Red flags

Be careful if an advisor won’t say who pays them, pushes you to decide quickly, sends your details to many communities at once, or can’t explain how a place was checked. Several calls within minutes of filling in one form usually means your details went to more than one place.

Check for yourself too

Whatever an agency tells you, look up the community’s state license and inspection record, and for nursing homes the Medicare Care Compare page. Your local long-term care ombudsman can tell you what complaints look like in your area. Then visit, more than once if you can, at different times of day. On Nana’s List, facilities pay nothing, we take no referral fees, and Nana’s grade ignores payment. Take the quiz to see how places near you compare on the things you care about.